[Evaluation of dynamic pituitary function testing in patients with hyperprolactinemia on diagnosis of pituitary prolactin-secreting adenoma (author's transl)].
Thirty hyperprolactinemic women were divided into four group according to radiological and computed tomographic findings of sella turcica as follows; sulpiride-induced (N = 7), functional (N = 6), microadenoma (N = 9) and macroadenoma (N = 8). It was measured the serum basal level of pituitary LH, FSH, PRL, TSH and GH, and the responsiveness to LH-RH, TRH, insulin administration, respectively. These values were compared to that during bromocriptine treatment (5mg/day, 2 weeks). Before and during treatment with bromocriptine, there were not significant changes of basal level of LH, FSH and TSH, and also the responsiveness to LH-RH administration in four group. In pretreatment period, PRL responsiveness to TRH was good in sulpiride-induced and functional groups, but decreased in microadenoma and macroadenoma groups. During bromocriptine treatment period, basal PRL level was significantly suppressed in three groups except sulpiride-induced group, and PRL responsiveness to TRH was good in three groups except macroadenoma group. These findings ae concluded as follows: 1) Mechanism of the disturbance of ovulation in hyperprolactinemia does not closely related to pituitary gonadotroph dysfunction. 2) Decreased PRL responsiveness to TRH (maximal fold increase: under 40%) is of diagnostic value of pituitary adenomas. 3) Difference of PRL responsiveness to TRH during treatment with bromocriptine is distinguishing the microadenoma from macroadenoma.
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D010902:Pituitary Gland / Q000503:physiopathology*; D010908:Pituitary Hormones, Anterior / Q000097:blood; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D011388:Prolactin / Q000097:blood* / Q000378:metabolism; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D010908:Pituitary Hormones, Anterior; D014284:Triiodothyronine; D007987:Gonadotropin-Releasing Hormone; D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin; D013974:Thyroxine